<p> George Road, Kingston upon Thames, Surrey KT2 7PB School: 020 8942 2247 Bursar: 020 8949 2908 Fax: 020 8942 5707</p><p>APPLICATION FOR POST AT ROKEBY SCHOOL</p><p>Please send the completed form with a covering letter for the attention of the Headmaster, Mr J R Peck. If any areas of the application are not completed fully, the application will be discounted. Email to:[email protected]</p><p>The closing date for this position is: Noon on 15th May 2017, however, suitable candidates will be interviewed upon receipt of an application.</p><p>Post Applied for: Head of Geography</p><p>Where did you see this advertisement:</p><p>Surname: First Name (s): </p><p>Preferred Title: Former Surname:</p><p>Address: Home Number:</p><p>Work Number:</p><p>Mobile Number:</p><p>*Email Address:</p><p>*Please supply a current email so that we can acknowledge your application.</p><p>Postcode:</p><p>Please state if you are applying for Full-Time or Part-Time:</p><p>If position is Part-Time or Temporary From: To: please state your availability.</p><p>Start Date – please state when you are able to start:</p><p>Have you applied to Rokeby before for a position (if so please give details):</p><p>Do you have Qualified Teacher Status? National Insurance Number:</p><p>DfE Number:</p><p>Do you have the legal right to work in the UK? YES/NO</p><p>If you hold a non EU passport do you have a right to work in the UK? YES/NO - and do you hold a permanent residency order ? YES/NO</p><p>If YES, are there any conditions attached? Please specify:</p><p>If NO, what type of work permit do you require?</p><p>EDUCATION & QUALIFICATIONS </p><p>Please include higher education exam results (eg. A Levels, IB results) for teaching positions. Dates of School/College/University Qualification/Degr attendance ee PREVIOUS AND PRESENT EMPLOYMENT (please continue on a separate sheet if necessary. Please give a reason for leaving and explain any gaps in your employment history)</p><p>Dates Position/Duties Name & Address of Employer Reason for Leaving</p><p>Please attach a Curriculum Vitae to this application form giving details of all employment explaining reasons for leaving and any gaps in your working career any relevant qualifications applicable and/or experience gained for the position applied for.</p><p>COURSES/CONFERENCES ATTENDED (over the past three years)</p><p>Date Course/Conference</p><p>HOBBIES & INTERESTS </p><p>EXTRA-CURRICULAR ACTIVITIES Please describe any proposed extra-curricular activities contribution at Rokeby </p><p>REFEREES</p><p>Please provide details of at least two referees, neither should be a relative or someone known to you solely as a friend. One should be your present or most recent employer.</p><p>Referee 1</p><p>Name: ……………………………………… Job Title: …………………………………..</p><p>Address:…………………………………….. Tel No: ……………………………………</p><p>…………………………………….. Email:……………………………………..</p><p>…………………………………….. </p><p>.…………………………………….. Referee 2</p><p>Name: ……………………………………… Job Title: …………………………………..</p><p>Address:…………………………………….. Tel No: ……………………………………</p><p>…………………………………….. Email:……………………………………..</p><p>…………………………………….. </p><p>.…………………………………….. </p><p>It is the post-holder’s responsibility to promote and safeguard the welfare of children and young persons for whom he/she is responsible, or with whom he/she comes into contact and to adhere to and ensure compliance with the school’s Safeguarding Policy at all times. A copy of this can be found on our website at www.rokebyschool.co.uk. If in the course of carrying out the duties of the post the post-holder becomes aware of any actual or potential risks to the safety or welfare or children in the school he/she must report any concerns to the school’s child protection officer or to the Headmaster.</p><p>I declare that all the information given in this form and any accompanying documents is true and correct. I understand that any omission or false statement on this form may justify my summary dismissal should I be appointed. The information on this form may be processed in accordance with the Data Protection Act 1998. </p><p>I have attached details of any convictions, cautions or bind-overs in a sealed envelope marked confidential.</p><p>Signed: ______</p><p>Date: ______</p>